Need for Cognition and Message Complexity in Motivating Fruit and Vegetable Intake Among Callers to the Cancer Information Service

This field experiment examined the impact of an individual\u27s need for cognition (NFC; the tendency to enjoy thinking deeply about issues), complex versus simple messages, and the interaction of NFC and message type on encouraging fruit and vegetable consumption. Callers to the Cancer Information Service of the National Cancer Institute (N = 517) were asked to participate in the experiment at the end of their call. Individual NFC was assessed, and participants were assigned randomly to receive a telephone message promoting fruit and vegetable consumption that was either complex and multifaceted or simple and straightforward. Similarly constructed brochures were mailed immediately following the call, and additional brochures were mailed 2 and 3 months later. Although NFC did not predict intake, complex messages were more effective than simple messages in motivating fruit and vegetable consumption 1 and 4 months later

Tailoring Messages to Individual Differences in Monitoring- Blunting Styles to Increase Fruit and Vegetable Intake

Objective To examine whether messages matched to individuals\u27 monitoring-blunting coping styles (MBCS) are more effective in increasing fruit and vegetable intake than mismatched messages. MBCS refers to the tendency to either attend to and amplify, or distract oneself from and minimize threatening information. Design/Setting Randomly assigned messages were tailored to resonate with either monitors or blunters and delivered at baseline, 1 week, 2 months, and 3 months later. Surveys were conducted at baseline and 2 and 4 months later. Participants 531 callers to a cancer information hotline who did not meet the 5 A Day guideline. Intervention A brief telephone-delivered message and 3 mailings of booklets and promotional items encouraging fruit and vegetable intake, tailored for either monitors or blunters. Main Outcome Measure Fruit and vegetable intake 2 and 4 months post-baseline. Analysis Hierarchical regression modeling. Results Messages matched to MBCS were more effective than mismatched messages, particularly for the monitor message, in increasing intake at 2 months but not at 4 months. Conclusions and Implications These minimal interventions influenced fruit and vegetable intake. MBCS may be a promising target for developing tailored messages aimed at increasing intake, although additional research is needed to verify the robustness of these findings

Casting Health Messages in Terms of Responsibility for Dietary Change: Increasing Fruit and Vegetable Consumption

Objective To compare the effectiveness of messages emphasizing the importance of either personal or social responsibility for dietary behavior change in increasing fruit and vegetable intake. Design/Setting Randomly assigned individually or socially oriented messages were delivered at baseline, 1 week, and 2 and 3 months later. Telephone surveys were conducted at baseline and 1 and 4 months later. Participants 528 callers to a cancer information hotline who were not meeting the “5 A Day” dietary recommendation. Interventions A brief telephone-delivered message and 3 mailings of pamphlets and promotional items encouraging fruit and vegetable intake that emphasized either personal or social responsibility. Main Outcome Measures Fruit and vegetable intake 1 and 4 months postbaseline. Analysis Chi-square, t tests, and analyses of variance and covariance. Results Both types of messages increased intake substantially (P = .01). To some extent, the social responsibility message continued to motivate increased intake over time compared with the personal responsibility message. Conclusions and Implications These minimal interventions had a substantial impact on fruit and vegetable intake. Health messages might be more effective over the longer term if they are designed to emphasize the importance of social responsibility, although further study is needed to confirm the robustness of these findings

Translating Medical Evidence to Promote Informed Health Care Decisions: Decision Making about PSA

To examine the effects of a community-based intervention on decisions about prostate-specific antigen (PSA) screening using multiple measures of informed decision making (IDM)

Behind Closed Doors: What Happens when Patients and Providers Talk about Prostate-Specific Antigen Screening?: Survey of the Effects of a Community-Based Intervention

Background: Prostate-specific antigen (PSA) screening is controversial because of uncertainty about whether it reduces mortality and whether the potential benefits outweigh the harms. Given these uncertainties, many medical associations recommend using an informed decision-making (IDM) process for making decisions about PSA screening, so that men can make well informed decisions that reflect their values and preferences. Objective: The aim of this paper was to describe the communication exchange between men and their providers regarding PSA screening and the outcomes associated with having a discussion about screening from the patient perspective. Methods: We evaluated survey results obtained at baseline and approximately 12 months post-intervention. Baseline data collection took place in community-based organizations, and follow-up data were collected by mail. Men between 40 and 80 years of age who had not been diagnosed with prostate cancer were eligible for the study. We implemented a multicomponent, community-based intervention designed to help men make informed decisions about PSA screening. Primary outcome measures included characteristics of patient-provider discussions, screening behavior, feeling informed and satisfied, and patients' preferred and actual levels of involvement in screening decisions and concordance between the two. Results: Overall, 59% of men (220 of 373) had a discussion with a healthcare professional about the PSA screening test. Older men (those aged ≥50 years), Black men, and those who were married were more likely to talk to a provider. When a discussion did occur, two out of three men said that the discussion affected their decision making, and one-quarter changed their screening choice as a result. According to patients, there was apparent variation regarding the extent to which providers recommended the PSA test: 68% of providers recommended it and 3% did not recommend it. One in ten men said that the provider ordered the test without making a recommendation, while 15% of men said that providers did not make a recommendation and wanted the patient to decide. We found that the discussion between the patient and the provider about PSA screening was significantly associated with a greater probability of feeling informed and higher levels of satisfaction with the decision that was made. Most men preferred to be and were involved in the PSA screening decision collaboratively with their providers. When preferred and actual levels of involvement were concordant (i.e. men participated at their preferred level) and when men asked questions, men reported feeling more informed and satisfied about the screening decision. Conclusion: Ongoing education about the US Preventive Services Task Force (USPSTF) recommendation with respect to PSA screening should occur not only at the patient level but also at the provider level. More widespread adoption of the IDM process, which inherently involves building a patient's self-efficacy and skills needed to engage in it, is likely to take time.